Healthcare Provider Details

I. General information

NPI: 1902017643
Provider Name (Legal Business Name): MRS. PAULA AILEEN FITZGERALD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 05/03/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 W 5TH ST STE. #590
SANTA ANA CA
92701-4519
US

IV. Provider business mailing address

204 PARROT LN
FOUNTAIN VALLEY CA
92708-5720
US

V. Phone/Fax

Practice location:
  • Phone: 714-834-5015
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: